Sudden Illness<div id="article-content-body"> <p>A 21-month-old previously healthy child is brought to the pediatrician's office because of increasingly labored breathing that began the night before. The father reports that the child has had fever, congestion, nonproductive cough, and irritability for 2 days and that she is slightly hoarse. Oral intake has decreased, but there is no drooling or dysphagia.</p> </div>
- <div id="article-content-body"><p><img src="/sites/default/files/images/Gregory%20W%20Rutecki%2C%20MD.jpg" style="float: left; margin-left: 8px; margin-right: 8px;" width="150" height="176">The challenge in treating venous thromboembolism (VTE) is to prevent recurrent events without significantly increasing the risk of bleeding. What duration of therapy best achieves this goal? Until now, studies have yielded conflicting answers.</p></div>
Hypertension and PalpitationsIn patients who have a coarctation, the narrowing of the lumen of the aorta obstructs blood flow and thereby raises blood pressure.
stuffThe potential for ocular side effects in patients taking selective phosphodiesterase (PDE) 5 inhibitors has been documented. The most common visual symptoms associated with the PDE 5 inhibitors are the development of a transient bluish tinge or haze and a sense of increased light sensitivity.
Abdominal Bruit of Unusual Origin<p><em><img alt="" height="123" src="/sites/default/files/images/ConCPBruitF2.jpg" style="float:left" width="150" /></em>A 52-year-old man with a 29-year history of type 1 diabetes mellitus and mild diabetic retinopathy and nephropathy presents for a regular checkup. He has not had any macrovascular diabetes-related complications. His average hemoglobin A<sub>1c</sub> level for the past 10 years has been 7.5%.</p>
Pain, Chest pain, Chest Pain and PalpitationsA 35-year-old woman presents to the emergency department with palpitations and chest pain. She is aware of her heart beating fast but not irregularly. She notes associated discomfort in the center of her chest. She denies dyspnea, light-headedness, diaphoresis, and nausea.
Cough and Dyspnea<div id="article-content-body"> <p><em><img alt="" src="/sites/default/files/images/ConCPEmpy3.jpg" style="border:1px solid black; height:139px; margin-left:8px; margin-right:8px; width:150px; float:left" /></em>A 52-year-old man with hypertension and hyperlipidemia presents to the emergency department with a 5-month history of cough and dyspnea. Despite several courses of oral antibiotics, the patient's dyspnea has worsened; his cough has persisted and now produces foul-smelling brown sputum. He denies fever, chills, and rigors. His appetite is only fair; he lost 8 lb during the month before this evaluation. He is a long-time smoker but has no history of alcohol or substance abuse.</p> </div>
Pressure Ulcers<div id="article-content-body"><p>Pressure ulcers occur frequently in elderly, hospice, and spinal cord injury patients. They affect 5% to 10% of patients in all health care facilities and add substantially to health care expenses. The average cost of treatment ranges from $20,000 to $70,000, depending on the stage of the ulcer.</p></div>
Headache and Neurologic Deficit<div id="article-content-body"><p><strong></strong>A 32-year-old woman complains of severe throbbing pain at the top of her head; numbness and weakness on the left side of her face and in her left arm and leg; and nausea, vomiting, and light and noise sensitivity. She rates the severity of the pain as 8 on a 10-point scale. The headache started about 36 hours earlier, with pain in the left temporal area. </p></div>
tips and tricks<div id="article-content-body"> <p><strong>Saddle Up for Jugular Venous Pressure Assessment</strong></p> <p><strong>Cleaner Catch Urine in Girls</strong></p> </div>